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BioMed Research International
Volume 2014, Article ID 345910, 11 pages
Research Article

Repair of Segmental Load-Bearing Bone Defect by Autologous Mesenchymal Stem Cells and Plasma-Derived Fibrin Impregnated Ceramic Block Results in Early Recovery of Limb Function

1Tissue Engineering Centre, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000 Kuala Lumpur, Malaysia
2Department of Orthopaedics and Traumatology, Kuala Lumpur General Hospital, 50586 Kuala Lumpur, Malaysia
3Orthopaedic, Traumatology and Spinal Surgery Consultant Clinic, Johor Specialist Hospital, 80100 Johor Bahru, Malaysia
4Materials Technology Group (MTEG), Industrial Technology Division (BTI), Malaysian Nuclear Agency, Bangi, 43000 Kajang, Selangor, Malaysia
5UKM Animal Resource Centre, Medical Faculty, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia
6Department of Pathology, Universiti Kebangsaan Malaysia Medical Centre, 56000 Kuala Lumpur, Malaysia
7Department of Radiology, Universiti Kebangsaan Malaysia Medical Centre, 56000 Kuala Lumpur, Malaysia
8Ear, Nose & Throat Consultant Clinic, Ampang Puteri Specialist Hospital, 68000 Ampang, Malaysia
9Department of Physiology, Medical Faculty, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia

Received 24 January 2014; Revised 9 June 2014; Accepted 9 June 2014; Published 8 July 2014

Academic Editor: Aaron W. James

Copyright © 2014 Min Hwei Ng et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Calcium phosphate-based bone substitutes have not been used to repair load-bearing bone defects due to their weak mechanical property. In this study, we reevaluated the functional outcomes of combining ceramic block with osteogenic-induced mesenchymal stem cells and platelet-rich plasma (TEB) to repair critical-sized segmental tibial defect. Comparisons were made with fresh marrow-impregnated ceramic block (MIC) and partially demineralized allogeneic bone block (ALLO). Six New Zealand White female rabbits were used in each study group and three rabbits with no implants were used as negative controls. By Day 90, 4/6 rabbits in TEB group and 2/6 in ALLO and MIC groups resumed normal gait pattern. Union was achieved significantly faster in TEB group with a radiological score of 4.50 ± 0.78 versus ALLO (1.06 ± 0.32), MIC (1.28 ± 0.24), and negative controls (0). Histologically, TEB group scored the highest percentage of new bone (82% ± 5.1%) compared to ALLO (5% ± 2.5%) and MIC (26% ± 5.2%). Biomechanically, TEB-treated tibiae achieved the highest compressive strength (43.50 ± 12.72 MPa) compared to those treated with ALLO (15.15 ± 3.57 MPa) and MIC (23.28 ± 6.14 MPa). In conclusion, TEB can repair critical-sized segmental load-bearing bone defects and restore limb function.